| NPI | 1508101965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KS 53-77781) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-77781) |
| 363LF0000X Nurse Practitioner Family (Licence: NM CNP-02095) | |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2025-09-04 |